颌骨前移治疗阻塞性睡眠呼吸暂停低通气综合征的CT研究

目的探讨阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）外科治疗的解剖形态学基础。方法小下颌畸形伴OSAHS患者共9例，平均年龄28．6岁（18—39岁），所有患者均经正颌外科和（或）颌骨牵引成骨治疗，手术前、后行多道睡眠监测仪监测及螺旋CT扫描，分别评价手术疗效并比较患者上气道三维结构的变化。结果9例患者经外科治疗后均达临床治愈标准；手术后上气道的矢状径、横径、横截面积及容积均较术前明显增加，其中矢状径的增加最显著，变化主要发生在口咽及舌咽，喉咽变化不明显。结论正颌外科及颌骨牵引成骨是使腭咽及舌咽的矢状径增加从而有效治疗小下颌畸伴OSAHS。     

The Age-Related Orientational Changes of Human Semicircular Canals

ObjectivesSome changes are found in the labyrinth anatomy during postnatal development. Although the spatial orientation of semicircular canals was thought to be stable after birth, we investigated the age-related orientational changes of human semicircular canals during development.MethodsWe retrospectively studied the computed tomography (CT) images of both ears of 76 subjects ranged from 1 to 70 years old. They were divided into 4 groups: group A (1–6 years), group B (7–12 years), group C (13–18 years), and group D (>18 years). The anatomical landmarks of the inner ear structures were determined from CT images. Their coordinates were imported into MATLAB software for calculating the semicircular canals orientation, angles between semicircular canal planes and the jugular bulb (JB) position. Differences between age groups were analyzed using multivariate statistics. Relationships between variables were analyzed using Pearson analysis.ResultsThe angle between the anterior semicircular canal plane and the coronal plane, and the angle between the horizontal semicircular canal plane and the coronal plane were smaller in group D than those in group A (P<0.05). The JB position, especially the anteroposterior position of right JB, correlated to the semicircular canals orientation (P<0.05). However, no statistically significant differences in the angles between ipsilateral canal planes among different age groups were found.ConclusionThe semicircular canals had tendencies to tilt anteriorly simultaneously as a whole with age. The JB position correlated to the spatial arrangement of semicircular canals, especially the right JB. Our calculation method helps detect developmental and pathological changes in vestibular anatomy.     

Observation of changes in the number of myocardial capillaries in rabbits after treatment of acute myocardial infarction by Tongxinluo superfine powder

OBJECTIVE

To investigate the effects of Tongxinluo superfine powder on cardiac function, infarct size and the number of myocardial capillaries in a rabbit model of acute myocardial infarction.

症状、CT和鼻声反射在慢性鼻窦炎组织重构诊断中的意义

目的探讨鼻塞症状、CT扫描Lund-Mackay评分和鼻声反射测量鼻黏膜充血指数与慢性鼻及鼻窦炎(chronic rhinosinusitis,CRS)组织重构程度之间的相关性,探讨三者在CRS组织重构诊断中的意义。方法选取CRS患者43例,应用视觉模拟评分(visual analogous scale,VAS)系统评价鼻塞症状;Lund- Mackay平分系统评价鼻窦CT扫描结果;鼻声反射测量获取鼻黏膜充血指数;钩突黏膜组织标本行鼻黏膜纤维化程度评分。应用统计学方法对其相关性进行分析。结果鼻塞症状严重程度与鼻黏膜纤维化程度之间无明显相关性(r=-0.046,P=0.77);CT评分与黏膜组织纤维化评分之间无相关性(r=0.132,P=0.40);鼻黏膜纤维化程度与鼻黏膜充血指数之间呈负相关(r=-0.348, P=0.022)。结论鼻黏膜充血指数能够反映病变黏膜的组织重构程度,辅助症状与CT检查指导CRS治疗策略。     

鼻上颌骨复合体三维有限元模型的建立

目的通过建立鼻上颌骨复合体三维有限元模型,探讨三维有限元模型的建立方法,为研究鼻上颌骨复合体的生物力学特性提供基础。方法螺旋CT薄层扫描获取医学数字成像与通讯标准（digital imaging and communications in medicine,DICOM）格式数据文件,导入三维重建软件Mimics,并应用有限元软件Ansys建立鼻上颌骨复合体三维有限元模型。结果用该方法所建立鼻上颌骨复合体三维有限元模型与实体有很好的相似性,并且操作误差小,建模分辨率高。结论应用DICOM数据计算机辅助建模法是一种快捷、准确、高效的有限元建模方法,该实验所建鼻上颌骨复合体三维有限元模型精确度高,操作的可重复性好,能为临床研究鼻上颌骨复合体骨折的生物力学的机制提供基础。     

256层螺旋CT在肺撕裂伤诊断中的应用

目的 总结肺撕裂伤的影像学特征及损伤机制、演变规律。方法 选取符合标准的肺撕裂伤患者32位患者48处病灶的CT图像进行回顾性分析。结果 圆形/类圆形组病灶与不规则形组病灶分布差异有统计学意义(P<0.05);并不是所有的病例,都必须经过气囊、气液囊、血肿3个阶段;32处病灶靠近胸膜下,16处位于非胸膜下,比较不同演变形式肺撕裂伤病灶的分布情况,差异无统计学意义(P>0.05);肺组织实变加重可使病灶缩小或消失;所有病灶复查中均未继续增大。结论 肺撕裂伤的3个演变形式为气囊、气液囊、血肿,256层螺旋CT及其后处理技术可以较好的观察肺撕裂伤的形态分布等特征,对于及时正确诊断具有重要价值。     

60例正常歼击机飞行员颈椎间孔X线测量分析（摘要）

目的测量颈椎间孔的大小,探讨我国歼击机飞行员高G载荷对其颈椎组织可能产生的影响。方法选取60例无临床症状经x线片检查诊断为正常的现役男性歼击机飞行员,测量颈椎间孔的前后径及上下径。结果各椎间孔的前后径及上下径自上向下逐渐变小,相邻椎间孔的前后径及上下径经t检验均有显著性差异（P〈0．05）,推间孔95％正常值的上下限可以做为制定同序数颈椎间孔是否属于正常的界值。结论高G载荷下,颈椎间孔大小与颈椎病变密切相关。     

各机种飞行员颈椎X线对比分析（摘要）

目的探讨飞行环境对各机种飞行员颈椎及周围软组织产生的影响。方法对83名歼击机、强击机和80名运输机、轰炸机飞行员颈椎X线表现进行对比分析。结果歼击机、强击机飞行员与运输机、轰炸机飞行员颈椎分类X线表现中,椎体不稳有非常显著差异,项韧带钙化有明显差异,生理曲度异常35岁（含35岁）以下有明显差异。结论持续性过载作用对颈椎及周围软组织产生急性损伤。     

移动式X射线机

概述了移动式X射线机的工作原理、基本结构、存在的问题及发展前景,为购置提供了良好的建议。     

无功能性胰岛细胞瘤的CT诊断

目的 探讨无功能性胰岛细胞瘤(NFICT)的CT表现.方法 回顾性分析经手术并经病理证实的17例NFICT的CT平扫和增强扫描所见.增强剂采用非离子型碘对比剂90 mL,注射流率3mL/s,测量胰腺和肿瘤动、静脉双期CT值.结果 CT扫描全组均发现肿瘤.平扫时肿瘤与胰腺实质比较,2例肿瘤为低密度,11例为混合性低密度,4例为等密度.5例于肿瘤内见限局性钙化.增强扫描17例肿瘤均有程度不同的强化.动脉期明显强化5例,中等强化6例,轻度强化6例.结论 NFICT的CT平扫表现为界限清楚的肿瘤,部分瘤体内有钙化.增强扫描肿瘤均有程度不同的强化,从动脉期到门静脉期呈持续性强化是NFICT的特征性表现.